Tooth development or odontogenesis is the complex process by which tooth form from embryonic cells,grow, and erupt into the mouth. For human teeth to have a healthy oral environment, all parts of the tooth must develop during appropriate stages of fetal development. Primary (baby) teeth start to form between the sixth and eighth week of prenatal development, and permanent teeth begin to form in the twentieth week. If teeth do not start to develop at or near these times, they will not develop at all, resulting in Hypodontia or Anodontia.
Tooth development is commonly divided into the following stages: the initiation stage, the bud stage, the cap stage, the bell stage, and finally maturation.
One of the earliest signs in the formation of a tooth that can be seen microscopically is the distinction between the vestibular lamina and the dental lamina. The dental lamina connects the developing tooth bud to the epithelial layer of the mouth for a significant time. This is regarded as the initiation stage.
The bud stage is characterized by the appearance of a tooth bud without a clear arrangement of cells. The stage technically begins once epithelial cells proliferate into the ectomesenchyme of the jaw. Typically, this occurs when the fetus is around 8 weeks old. The tooth bud itself is the group of cells at the periphery of the dental lamina.
Along with the formation of the dental lamina, 10 round epithelial structures, each referred to as a bud, develop at the distal aspect of the dental lamina of each arch. These correspond to the 10 primary teeth of each dental arch, and they signify the bud stage of tooth development. Each bud is separated from the ectomesenchyme by a basement membrane. Ectomesenchymal cells congregate deep to the bud, forming a cluster of cells, which is the initiation of the condensation of the ectomesenchyme. The remaining ectomesenchymal cells are arranged in a more or less haphazardly uniform fashion.
The first signs of an arrangement of cells in the tooth bud occur in the cap stage. A small group of ectomesenchymal cells stops producing extracellular substances, which results in an aggregation of these cells called the dental papilla. At this point, the tooth bud grows around the ectomesenchymal aggregation, taking on the appearance of a cap, and becomes the enamel (or dental) organ covering the dental papilla. A condensation of ectomesenchymal cells called the dental sac or follicle surrounds the enamel organ and limits the dental papilla. Eventually, the enamel organ will produce enamel, the dental papilla will produce dentin and pulp, and the dental sac will produce all the supporting structures of a tooth, the periodontium.
The bell stage is known for the histodifferentiation and morphodifferentiation that takes place. The dental organ is bell-shaped during this stage, and the majority of its cells are called stellate reticulum because of their star-shaped appearance. The bell stage is divided into the early bell stage and the late bell stage. Cells on the periphery of the enamel organ separate into four important layers. Cuboidal cells on the periphery of the dental organ are known as outer enamel epithelium (OEE). The columnar cells of the enamel organ adjacent to the enamel papilla are known as inner enamel epithelium (IEE). The cells between the IEE and the stellate reticulum form a layer known as the stratum intermedium. The rim of the enamel organ where the outer and inner enamel epithelium join is called the cervical loop.
In summary, the layers in order of innermost to outermost consist of dentin, enamel (formed by IEE, or ‘ameloblasts’, as they move outwards/upwards), inner enamel epithelium and stratum intermedium (stratified cells that support the synthetic activity of the inner enamel epithelium) What follows is part of the initial ‘enamel organ’, the center of which is made up of stellate reticulum cells that serve to protect the enamel organ. This is all encased by the OEE layer.
Other events occur during the bell stage. The dental lamina disintegrates, leaving the developing teeth completely separated from the epithelium of the oral cavity; the two will not join again until the final eruption of the tooth into the mouth.
The crown of the tooth, which is influenced by the shape of the inner enamel epithelium, also takes shape during this stage.
Advanced Bell Stage
Hard tissues, including enamel and dentin, develop during the next stage of tooth development. This stage is called the crown, or maturation stage, by some researchers. Important cellular changes occur at this time. In prior stages, all of the IEE cells were dividing to increase the overall size of the tooth bud, but rapid dividing, called mitosis, stops during the crown stage at the location where the cusps of the teeth form. The first mineralized hard tissues form at this location. At the same time, the IEE cells change in shape from cuboidal to columnar and become pre-ameloblasts. The nuclei of these cells move closer to the stratum intermedium and away from the dental papilla as they become polarized.
The adjacent layer of cells in the dental papilla suddenly increases in size and differentiates into odontoblasts, which are the cells that form dentin. Researchers believe that the odontoblasts would not form if it were not for the changes occurring in the IEE.
As the changes to the IEE and the formation of odontoblasts continue from the tips of the cusps, the odontoblasts secrete a substance, an organic matrix, into their immediate surrounding. The organic matrix contains the material needed for dentin formation. As odontoblasts deposit organic matrix termed predentin, they migrate toward the centre of the dental papilla. Thus, unlike enamel, dentin starts forming in the surface closest to the outside of the tooth and proceeds inward. Cytoplasmic extensions are left behind as the odontoblasts move inward. The unique, tubular microscopic appearance of dentin is a result of the formation of dentin around these extensions.
After dentin formation begins, the cells of the IEE secrete an organic matrix against the dentin. This matrix immediately mineralizes and becomes the initial layer of the tooth’s enamel. Outside the dentin are the newly formed ameloblasts in response to the formation of dentin, which are cells that continue the process of enamel formation; therefore, enamel formation moves outwards, adding new material to the outer surface of the developing tooth.
At Corne Smith Dentistry, Claremont Cape Town not only do we understand the importance of tooth development from even before birth but also the importance of keeping your pearly whites healthy throughout your life, schedule your dental checkup with Dr Corne Smith now and get on track with oral health.